Carvalho Ana C, Pinho Juliana, Cancela Eugénia, Silva Américo
Department of Gastroenterology, Centro Hospitalar Tondela-Viseu, E.P.E., Viseu, Portugal.
ACG Case Rep J. 2023 Mar 13;10(3):e01009. doi: 10.14309/crj.0000000000001009. eCollection 2023 Mar.
Autoimmune enteropathy is a rare cause of malabsorption usually associated with circulating autoantibodies and predisposition to autoimmune disorders. The diagnosis is based on the following criteria: chronic diarrhea (>6 months), malabsorption, specific histological findings, anti-enterocyte and anti-goblet cell antibodies, and exclusion of similar disorders. We report a case of a 73-year-old woman presenting with severe chronic diarrhea, weight loss, and electrolyte abnormalities. Endoscopy revealed duodenal villous atrophy extending to proximal jejunum, and duodenal biopsies revealed villous blunting, cryptitis with apoptosis, and scattered intraepithelial lymphocytes. Therapeutic management included immunosuppressive treatment with corticosteroids, achieving clinical remission.
自身免疫性肠病是吸收不良的罕见病因，通常与循环自身抗体及自身免疫性疾病易感性相关。诊断基于以下标准：慢性腹泻（>6个月）、吸收不良、特定组织学表现、抗肠上皮细胞和抗杯状细胞抗体，以及排除类似疾病。我们报告一例73岁女性患者，表现为严重慢性腹泻、体重减轻和电解质异常。内镜检查显示十二指肠绒毛萎缩延伸至空肠近端，十二指肠活检显示绒毛变钝、伴有凋亡的隐窝炎及散在的上皮内淋巴细胞。治疗措施包括使用皮质类固醇进行免疫抑制治疗，从而实现临床缓解。
